Provider Demographics
NPI:1548401540
Name:WEBB, WILLIAM AVERY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:AVERY
Last Name:WEBB
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 WATERLOO ST SW
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3763
Mailing Address - Country:US
Mailing Address - Phone:806-648-8803
Mailing Address - Fax:
Practice Address - Street 1:160 WATERLOO ST SW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3763
Practice Address - Country:US
Practice Address - Phone:806-648-8803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-20
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC13021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice